Wednesday, April 20, 2016

"Next Steps" RE Appointment Update

Basically the appointment boiled down to us doing 3 months of Femara with timed intercourse.

We discussed moving onto IUIs, and my RE said that since we don't seem to have any problems with K's side of things, an IUI doesn't really increase our chances of conceiving. She said that if we are really antsy to conceive, she would be ok moving onto an IUI right now, but unfortunately K isn't able to take the time off work, and we don't currently have the funds. She agreed to three months of Femara to see if the different medication would force my body into working, but doesn't feel comfortable doing more than 6 months of induced ovulation with timed intercourse, (3 months of Clomid followed by 3 months of Femara.) She said that if these next three months don't work, then the next step would be IUI.

I asked about a trigger shot, and she said that she doesn't feel that a trigger shot would help our chances. She feels that our bodies know the right time to ovulate better than medicine does, so as long as I get an LH surge on OPKs, a trigger shot isn't necessary.

She said that it might be a good idea to get frequent monitoring with my first cycle of Femara to see how many eggs I'm producing, but that is difficult to do when I have to take an entire day off work to drive to, and from, my RE. I'm going to call my OB's office and see if they're willing to help out with some remote monitoring, but I'm not getting my hopes up because they're a very busy office.

When I got home tonight, I started bleeding. I'm only 9 days past ovulation, so I'm unsure if it's mid-cycle spotting, or if I'm starting my period super early (this was an unmedicated cycle.) I've never had bleeding at this point of my cycle, so I have nothing to compare it to. If I have started my period, I'm going to email my RE to see if a short luteal phase during an unmedicated cycle is something she's worried about.

As of right now, I'm unsure when our first Femara cycle will be. I'm traveling almost every weekend in May, and K isn't with me for most of it, so trying to time intercourse will be difficult if I ovulate while we're apart. My RE did send in a prescription for a month of birth control so that if we decide to skip May, I can continue to have a regular cycle and not have to worry about when my period will arrive.

I feel defeated that money and lack of free time is what is potentially stopping us from growing our family. If these next three cycles with Femara don't work out, K is going to have to have a serious sit down conversation with his boss about having to take at least one day a month off work. I'm also confused about if there's a point in doing IUI if it won't increase our chances of conceiving. Has anyone's RE said something similar? My RE also said that it won't increase our chances of multiples, which I'm not sure is accurate, either. Looking back at my records, K's last semen analysis was 3 years ago (to the very month!) so I'm not sure if we need to do another one, even though his numbers were good last time.

I'll do a short update come May about if we've decided to do a medicated cycle or not. Thank you as always for the support!


9 comments:

  1. Ok, this is just my experience and what I have heard. First, I conceived on Femara when I didn't on clovis (whether coincidence or due to the differented, idk). Also, bonus I had way less side effects from femara. The month I finally conceived I also had a trigger shot, which my RE claws would not only induce ovulation but make it strongER (not sure exactly what that means). I did have extra ultrasounds to help determine when to do the shot, which I found helpful. As for IUI, I think in some cases it can overcome issues with a woman that maybe aren't as easily diagnosible. A friend had some sort of issue with her cervical mucus being unfriendly to sperm, and they finally conceiveD with an IUI. Again, this is just what I have experienced or been told. Best of luck!

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    1. Thank you for your thoughts! My RE did say I should have less side effects on Femara, so I'm excited for that!

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  2. Ok, this is just my experience and what I have heard. First, I conceived on Femara when I didn't on clovis (whether coincidence or due to the differented, idk). Also, bonus I had way less side effects from femara. The month I finally conceived I also had a trigger shot, which my RE claws would not only induce ovulation but make it strongER (not sure exactly what that means). I did have extra ultrasounds to help determine when to do the shot, which I found helpful. As for IUI, I think in some cases it can overcome issues with a woman that maybe aren't as easily diagnosible. A friend had some sort of issue with her cervical mucus being unfriendly to sperm, and they finally conceiveD with an IUI. Again, this is just what I have experienced or been told. Best of luck!

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  3. This cycle sounds a lot like the one I conceived Kyle. The Great Debacle I called it. I ovulated while my husband was away and somehow, the sperm made it 3 days till I released an egg. So, you never know!

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    1. That gives me hope! I think we'll decide if we're going to try this cycle depending on when my period comes. I ovulate pretty reliably on CD 14 or 15, so if I'll be away during that time, we'll probably skip this cycle. Thank you for the encouragement!

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  4. I'm sorry you're running into so many obstacles. I hate that lack of time and money is getting in the way. Honestly, I think if you're going to bother at all with medication, you should be monitored via ultrasound and blood work to make sure you're responding appropriately, and to avoid multiples (you can cancel a cycle in which you produce too many lead follicles). Multiples are a risk with medicated cycles, whether you do IUI or not. (Less of a chance with IVF, because you can choose to transfer only one embryo, while you can't choose to ovulate only one follicle.) I realize it's not convenient, but I would push for full monitoring. I also think IUI would increase your chances, if only because then you can control the timing much better and not have the added stress of performing on demand. Plus, doesn't the washing process leave just the strongest swimmers? It sounds like your RE likes the conservative approach, which would be fine if you were okay with that. My RE, on the other hand, loves to control every aspect. Even on TI cycles, I always triggered and was fully monitored. I also did my monitoring remotely, since the RE is 200 miles away from me.

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    1. I think my RE has such a conservative approach because she knows that we have to drive 3 hours to come see her, and neither one of us is able to take that much time off work, so she's not pushing for monitoring yet. If my OB is able to do some monitoring, I'm going to do that for sure.

      Interesting idea about the chances of multiples with medicated cycles vs. IVF. I had never thought of it that way, but it totally makes sense!

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  5. I was on Femara for a couple of months with IUI, and as Melissa said, the side effects for me were waaaay better than Clomid. So there’s that to look forward to if you go that route. But yeah, I hear you…it sucks that time invested in appts and money are such big contributors to this process. Doesn’t seem fair.

    As for the IUI or not, my RE explained them as taking out a huge and long obstacle for the sperm getting all the way up there to meet the egg. Apparently a lot can prevent it from getting there, so this places them right where they need to be. Neither of us had any known issues at the time, and we were given a higher % of success for it vs naturally. However, as you may know, IUI did not work for us. I think it is often a good next step, but of course depends on each couple’s situation as to how much more efficient/successful it could be.

    I do know that any time you are using medication to assist ovulation, you are increasing your chances for multiples, as it is trying to push your body to generate more mature follies to improve your chances one works. Perhaps your RE means that whether the meds are with IUI or not, that doesn’t change? I’m only going off of my memory of how it was explained to me.

    Maybe you can do a phone consult with another RE for a second opinion, if you are wondering about this?

    Regardless, I am sorry you are dealing with such tough decisions, and I hope the right approach for you becomes clear soon.

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    1. I think that my RE was saying that adding an IUI to a Femara or Clomid cycle doesn't necessarily increase our chances, since my husband seems to be free of problems. I don't know about if I agree, since getting rid of dead sperm and placing them where they need to be seems like it would increase our chances!

      She is willing to move to an IUI as soon as we want to, so we'll do that when we feel the time is right. Thank you for comments!

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